Clinical management of lung cancer patients with respiratory symptoms during the COVID-19 pandemic

Abstract

Objective: There are many clinical conditions, such as lung cancer, that need to be followed up and treated during a pandemic. Providing health care for patients who are immune-suppressive requires extra care. Method: Among 108 lung cancer patients who had been hospitalized during the COVID-19 pandemic, 18 with respiratory symptoms were evaluated retrospectively. Results: The patients’ median age was 64 ± 9.4 with a male predominance (male n = 16, female n = 2). Thirteen had non-small cell lung cancer (NSCLC), and 5 had small cell lung cancer (SCLC). Nine (50%) patients were receiving chemotherapy. The most common symptom was shortness of breath (n = 14, 77.8%), followed by fever (n = 10, 55.6%). The findings confirmed on computed thorax tomography (CTT) were as follows: consolidation (n = 8, 44.4%), ground glass opacities (n = 8, 44.4%) and thoracic tumour/mediastinal-hilar lymphadenopathy (n = 3, 16.7%). Hypoxia was seen in 11 patients (61.1%), twelve patients had an elevated LDH (median = 302 ± 197) and lymphopenia (median = 1055 ± 648) and 5 (27.7%) were highly suspected of having contracted COVID-19. None of their nasopharyngeal swaps was positive. Two of these 5 patients received COVID-19 specific treatment even though they thrice had negative reverse transcription polymerase chain reaction (RT-PCR) results. The two patients responded well to both clinical and radiological treatments. For one case with SCLC receiving immunotherapy, methylprednisolone was initiated for radiation pneumonitis after excluding COVID-19. Conclusion: In line with a country's health policies and the adequacy of its health system, the necessity of a multidisciplinary approach in the management and treatment of complications in patients with lung cancer has become even more important during the COVID-19 pandemic.